Eating disorders symptoms and excessive internet use in adolescents: the role of internalising and externalising problems

J Eat Disord. 2021 Nov 21;9(1):152. doi: 10.1186/s40337-021-00506-5.

Abstract

Background: Both eating disorders and excessive internet use represent significant health issues for contemporary adolescents. Yet, the link between them has seldom been investigated. We aim to study this association through their common underlying psychological factors: internalising problems and externalising problems.

Methods: A representative sample of 7,083 adolescents (Mage = 13.48 years; SDage = 1.32; 50.3% girls) from Slovakia was obtained from the Health Behaviour in School-aged Children (HBSC) project in 2018. Study variables included the Excessive Internet Use Scale (EIU) and the Strength and Difficulties Questionnaire (SDQ). Eating disorders symptoms (EDS) were assessed by SCOFF and selected items from the Eating Disorder Screen for Primary Care (ESP). Data were analysed separately for boys and girls with Structural Equation Modelling.

Results: There was a partial correlation between EDS and EIU (r = 0.36 for boys and r = 0.29 for girls) after controlling for the internalising and externalising of problems. Internalising and externalising problems were positively associated with EDS, while EIU was only associated with externalising problems. The results were comparable for both genders.

Conclusion: The study provides evidence that, during adolescence, EDS and EIU are related and have a tendency to occur together. Also, they are related even when controlled for their shared underlying psychological factors, namely the emotional and attentional/behavioural difficulties.

Keywords: Adolescents; Eating disorders symptoms; Excessive internet use; Externalising problems; Internalising problems.

Plain language summary

The study found that, in adolescents, eating disorders symptoms are associated with excessive internet use even when controlled for their shared psychological factors. Self-control issues were associated with both the eating disorder symptoms and excessive internet use, while emotional issues were only associated with the eating disorder symptoms. The strength of the relationship was similar for boys and girls, even though the prevalence of eating disorders symptoms was double in girls.